by Arie T. Scribbick, M.D. and Frank W. Scribbick, M.D.
HISTORY OF PRESENT ILLNESS:
A 23 year old male complains of 2 days of severe right eye pain, photophobia, blurred vision and foreign body sensation. There is no history of trauma. He has myopia for which he wears extended wear contact lenses. There is no history of trauma. His immunizations are current. The patient is otherwise healthy.
PHYSICAL EXAMINATION:
The patient is an alert male in moderate discomfort. His visual acuity is OD 20/200 without contact lens and 20/200 pinhole; OS is 20/30 with contact lens. Pupils are equal and 5 mm in dim light and constrict to 3 mm with penlight. There is direct and consensual photophobia. Extraocular movements are normal. There is no foreign body seen with double lid eversion. There is no preauricular adenopathy. Confrontational visual fields are normal. Fundus examination is normal. Fluorescein staining reveals a 2 mm circular area of uptake just superior to the visual axis. Slit lamp examination reveals an epithelial defect with a white infiltrate at its base in the same area of the fluorescein uptake. This infiltrate extends into the corneal stroma producing an ill-defined circular lesion. There is moderate cells and flare of the anterior chamber. The limbus is moderately injected. There is peripheral neovasuclarization of the peripheral cornea. The rest of the examination is normal.
LABORATORY:
No labs or ancillary studies were obtained
From Academic Emergency Medicine 1(4):412-413 1994 July/August
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